Methodology over metrics: Current scientific standards are a disservice to patients and society, 2021, Van Calster et al

Andy

Andy

Retired committee member
Highlights
  • The overall quality of medical research remains poor, despite longstanding criticisms.
  • The scientific enterprise is business-like and consistently undervalues its own backbone, methodology.
  • Despite great initiatives to improve research quality, progress is modest.
  • Top-down action from journals, funding agencies, universities and governments is needed to break the cycle. These actions should give methodology a central place in funding acquisition as well as study design, conduct, and reporting.
Abstract
Covid-19 research made it painfully clear that the scandal of poor medical research, as denounced by Altman in 1994, persists today. The overall quality of medical research remains poor, despite longstanding criticisms. The problems are well known, but the research community fails to properly address them. We suggest most problems stem from an underlying paradox: although methodology is undeniably the backbone of qualitative and responsible research, science consistently undervalues methodology. The focus remains more on the destination (research claims and metrics) than on the journey. Notwithstanding, research should serve society more than the reputation of those involved. While we notice that many initiatives are being established to improve components of the research cycle, these initiatives are too disjointed. The overall system is monolithic and slow to adapt. We assert that a top-down action is needed from journals, universities, funders and governments to break the cycle and put methodology first. These actions should involve the widespread adoption of registered reports, balanced research funding between innovative, incremental and methodological research projects, full recognition and demystification of peer review, mandatory statistical review of reports, adherence to reporting guidelines, and investment in methodological education and research. Currently, the scientific enterprise is doing a major disservice to patients and society.

Open access, https://www.jclinepi.com/article/S0895-4356(21)00170-0/fulltext
 
Andy said:
The overall quality of medical research remains poor, despite longstanding criticisms. The problems are well known, but the research community fails to properly address them.
Click to expand...
Andy said:
We assert that a top-down action is needed from journals, universities, funders and governments to break the cycle and put methodology first.
Click to expand...
Maybe Cochrane could lead the way by not using studies that have no scientific value in their reviews e.g. those relying on subjective outcomes in unblinded studies to prove a treatment works. Cochrane is a long way from being a leader for good science right now though. @Hilda Bastian
 
I think I have mentioned this before. It is never ever an issue of just one study or even a group of studies.

The problems mentioned above are systemic and are fatally injuring science in a way that will have horrifying repercussions that go beyond medicine. Why trust science at all if it can say anything you like, arrive at any destination you please for political or economic reasons.

I realise that people involved in scientific endeavours will have much to say that they think is nuanced and well reasoned but there is a lot of sophistry and justification of compromise (to accommodate the realities of politics and economics probably) that do not serve to illuminate but to obfuscate.

Society suffers.
 
a necessary fix would require a government watchdog that has real teeth . Academic and scientific fraud should have real world legal consequences ie lengthy prison sentences and unlimited fines for those who refuse to do their due diligence in filtering out this blight . at present the whole industry seems to be run as some sort of club with zero accountability for the massive amount of harm caused .
 
The 1994 paper by Altman that the authors refer to is also worth a read. it starts:
What should we think about a doctor who uses the wrong treatment, either wilfully or through ignorance, or who uses the right treatment wrongly (such as by giving the wrong dose of a drug)? Most people would agree that such behaviour was unprofessional, arguably unethical, and certainly unacceptable.

What, then, should we think about researchers who use the wrong techniques (either wilfully or in ignorance), use the right techniques wrongly, misinterpret their results, report their results selectively, cite the literature selectively, and draw unjustified conclusions? We should be appalled. Yet numerous studies of the medical literature, in both general and specialist journals, have shown that all of the above phenomena are common."-7 This is surely a scandal.
Click to expand...
Van Calster and colleagues comment on this paper, saying it "could have been written today, without changing a single word."
 
Last edited:
You must log in or register to reply here.
Back
Top